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Changing how we manage lung cancer

Charlie Dean

Charlie Dean, VP and GM, leads the Endoluminal business unit at Intuitive. That’s a very good thing when the problem you’re trying to address is this important: Charlie and his team are focused on enabling lung cancer detection. Below, Charlie reflects on Intuitive’s mission-driven culture, leading with the “why,” and making the leap from startups to Intuitive, where his love for “fixing things and making products work” continues.

Tell us about your team’s work. What does the endoluminal business unit do?

We work on Intuitive’s Ion product, which is a new breed of endoluminal robot—endoluminal means using natural orifices, such as the mouth, rather than incisions, in this case for pulmonary biopsy. Our current focus is enabling physicians to diagnose lung cancer, and we chose to start there because it’s one of the biggest, hardest problems we could apply robotics to. Lung cancer is potentially symptomless, which makes detection difficult, and detection of cancer at an early stage provides patients with higher odds of survival. 

Ion uses a patient’s CT scan to create a 3D model of the lung, and then allows the doctor to drive the catheter right where they need to go. Because Ion is so small and precise, it makes it possible for doctors to reach and biopsy difficult-to-reach nodules in the peripheral lung, where more than 70% of cancerous lung nodules may be located. That’s obviously very impactful in cases where the nodule does turn out to be cancer—especially if the patient is a candidate for surgery. And if the lesion is benign, they’re able to potentially avoid surgery altogether. Ion is helping doctors reimagine the patient journey in lung cancer diagnosis.

What brought you to Intuitive?

I fell into the medical field by chance. I studied mechanical engineering in college, and like most mechanical engineers, I wanted to be a Formula One driver, or at least help build the cars. So I got a job at Cosworth, an automotive engineering company, but I was impatient—I didn’t want to spend three years working on one component, and then maybe I’d get a chance to work on two. I had a mentor who connected me to a consulting company that did medical device development, and I ended up spending several years there, working with everyone from Pfizer and Johnson & Johnson to two-person startups. I got to contribute to dozens of devices, and I gravitated toward the minimally invasive products. 

Really, I’ve done that same job ever since, albeit with different companies and in different roles—I love fixing things, making products work, and then making a lot of them. In 2010, I joined Apollo Endosurgery, and I worked alongside Bob DeSantis, who is now Intuitive’s Chief Product Officer. We stayed in touch after he came here, and once Apollo had launched the product I was working on, he convinced me to at least meet the Intuitive team. I have to admit, I was thinking, “No way. I don’t want to work for a big company.” But I was really impressed. No one was resting on their laurels; it was well-funded but still a startup mentality. So I joined the team, and I’ve been here close to five years now.

What’s the culture like within the endoluminal business unit?

We’re very mission-driven, and really try to emphasize not just what we do but how. We all know the whole is greater than the sum of its parts, and I think that creates a very respectful, inclusive environment—people who are difficult to work with don’t do well at Intuitive, even if they’re brilliant. That doesn’t mean we always agree; we challenge each other plenty. But it’s always around what we’re doing, not who we are.

We also push hard. We know we’re in a race, and there’s a lot of grit on this team. People are prepared to go above and beyond. But we never want to push so hard that we’re burning people out, or losing sight of why we’re here in the first place. I think people stay at Intuitive because they care about the mission; they love what they’re doing, and they’re having fun. That’s why I stay! Plus, growing as quickly as we are—nearly half of Intuitive’s team has joined us in the last two years—means our individual team members can grow quickly, too. As a leadership team, we really try to be thoughtful about finding stretch opportunities for people. 

I’d also say we try to foster an environment where people don’t feel like they’re constrained—it’s part of our job as leaders to break through constraints when we need to. I was interviewing a job candidate the other day, and they asked me a great question: “How often do people say ’no’ to you?” I told them I hear “no” a fair amount—but I don’t think I’ve ever heard “never.” And I like to think everyone on this team would say the same.

What’s exciting now for the endoluminal business unit?

We’re the smallest business unit at Intuitive, but we’re also growing—we’re in that transition right now from early adopters to the majority. I think that’s a testament to the technology, and to the lessons we’ve been able to take from the da Vinci surgical system, which is now a fifth-generation product; Ion is much more advanced than you’d expect from a first-generation product, and even though we weren’t the first to market, we now appear to be the preferred robotic platform for lung biopsy. So, part of this moment is about keeping up with that demand—we’re tripling sales every year. But just because we think we have the best product doesn’t mean we stop. We want the next generation to be better, smaller, easier to use, and have improved imaging capabilities. 

We’re also talking about what the digital infrastructure could look like, which may be just as important as the robotics themselves. Ion is only one step in a lung cancer patient’s journey, and in our health care system, the tools available today to get from suspicion to diagnosis don’t move quickly enough right now. There’s some exciting work happening in artificial intelligence around things like proactively reviewing CT scans and other information to propose next steps and streamline that process.

Additionally, we have huge potential to expand beyond the mouth to other orifices, beyond lung cancer to other diseases, and beyond enabling diagnosis. Ion is fundamentally about access, and that opens up amazing possibilities. In the future, we’d like to be able to facilitate the treatment of the lesions we find, and we’re developing tools for that. But we’re also working on a lot of third-party collaborations. No one was thinking much about treatments for the periphery of the lung before, for example, because you couldn’t get there. Now that Ion has changed that, people are knocking on the door, and we want to facilitate all kinds of less-invasive, more localized procedures. That’s good for Intuitive, and it’s good for patients.

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Charlie Dean

Charlie Dean, VP and GM, leads the Endoluminal business unit at Intuitive. Charlie and his team are focused on enabling lung cancer detection.

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